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Resumen Introducción: El aumento de la concentración de dímero-D en pacientes COVID-19 se ha asociado a mayor gravedad y peor pronóstico; sin embargo, su rol en predecir el diagnóstico de tromboembolismo pulmonar (TEP), aún es incierto. Objetivo: Evaluar la utilidad del dímero-D plasmático en el diagnóstico de TEP en pacientes con COVID-19. Pacientes y Métodos: Estudio observacional analítico. Se incluyó a pacientes COVID-19 que tenían una angiotomografía computada de tórax (AngioTAC). Se registraron datos clínicos, niveles plasmáticos de dímero-D de ingreso y previo al momento de realizar la AngioTAC. Se identificó la presencia o ausencia de TEP. Resultados: Se incluyeron 163 pacientes; 37(23%) presentaron TEP. Al comparar la serie de pacientes con TEP versus sin TEP, no se encontraron diferencias significativas en características clínicas, ni mortalidad. Hubo diferencias significativas en el nivel plasmático del dímero-D previo a realizar la AngioTAC (3.929 versus 1.912 μg/L; p = 0,005). El área bajo la curva ROC del dímero-D para TEPfue de 0,65. El mejor punto de corte del dímero-D fue de 2.000 μg/L, con una baja sensibilidad y valor predictivo positivo. El valor de corte con el mejor valor predictivo negativo (VPN)fue de 900 μg/L (96%), el cual fue mejor que la estrategia de corte de dímero D ajustado por edad (VPN 90%). Conclusión: La capacidad discriminativa del dímero D para diagnosticar TEP fue baja. En cambio, el dímero D mantiene un alto valor predictivo negativo para descartar TEP, el cual es mayor al valor descrito clásicamente en los pacientes no COVID.
Introduction: Increased D-dimer concentration in COVID-19 patients has been associated with greater severity and worse prognosis; however its role in predicting the diagnosis of pulmonary thromboembolism (PTE), is still uncertain. Objective: To evaluate the usefulness of plasma D-dimer in the diagnosis of PTE in patients with COVID-19. Method: Analytical observational study. COVID-19 patients who had a chest computed tomography angiography (CTA) were included. Clinical data, Ddimer plasma levels on admission and prior to CTA were recorded. The presence or absence of PTE was identified. Results: 163 patients were included, 37 (23%) presented PTE. After comparing the series of patients with PTE versus the series without PTE, no significant differences were found in clinical characteristics or mortality. There were significant differences in the plasma level of D-dimer prior to performing CTA (3,929 μg/L versus. 1,912 μg/L; p = 0.005). The area under the D-dimer ROC curve for PTEprediction was 0.65. The best D-dimer cutoffpoint was 2.000μg/L, with a low sensitivity and positivepredictive value. The cutoff value with the best negativepredictive value (NPV) was 900 μg/L (96%), which was better than the age-adjusted D-dimer cutoff strategy (NPV 90%). Conclusion: The discriminative ability of D-dimer to diagnose PTE was low. In contrast, D-dimer maintains a high negative predictive value to rule out PTE, which is higher than the value classically described in non-COVID patients.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , COVID-19/complicações , Embolia Pulmonar/diagnóstico por imagem , Biomarcadores/análise , Valor Preditivo dos Testes , Curva ROC , Sensibilidade e Especificidade , Angiografia por Tomografia ComputadorizadaRESUMO
Four formulations of nanostructured lipid carriers (NLC) loaded with curcuminoids where prepared, testing two types of solid lipids (Compritol® 888 ATO and Precirol® ATO 5) and two kinds of stabilizers (poloxamer 407 and polysorbate 80). Particle size values between 111 and 214 nm and polydispersity indices < 0.3 were registered, with low Z potential values due to the nonionic character of the stabilizers. The results showed that the type of surfactant had an impact on the in vitro release rate and on the ex vivo skin permeation capability of curcuminoids. Polysorbate 80 delayed the release, but favors the transport of a higher amount of curcuminoids to the receptor solution during the ex vivo permeation studies than the systems with poloxamer 407. Confocal microscopy confirmed that all systems favored the penetration of curcuminoids to deeper layers of the skin and in a greater amount than curcuminoids in solution. Exposure of the systems to intense radiation caused the degradation of curcuminoids, without loss of antioxidant activity, confirming that the degradation products also function as antioxidants. The NLC prepared can be valuable carriers to enhance the penetration of curcuminoids into the skin, to treat different disorders and skin diseases.
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Nanopartículas , Nanoestruturas , Antioxidantes , Diarileptanoides , Portadores de Fármacos , Lipídeos , Tamanho da Partícula , PeleRESUMO
The colonization of an exotic species by native herbivores is more likely to occur if that herbivore is a generalist. There is little information on the life-history mechanisms used by native generalist insects to colonize exotic hosts and how these mechanisms are affected by host properties. We examined the ability of the generalist seed beetle Stator limbatus Horn to colonize an exotic species. We compared its host preference, acceptability, performance, and egg size when ovipositing and developing on two native (Pithecellobium dulce (Roxb.) Benth and Senegalia riparia (Kunth)) and one exotic legume species (Leucaena leucocephala (Lam.)). We also analyzed the seed chemistry. We found that females recognize the exotic species as an unfavorable host for larval development and that they delayed oviposition and laid fewer and larger eggs on the exotic species than on the native species. Survivorship on the exotic host was 0%. Additionally, seeds of the native species contain five chemical compounds that are absent in the exotic species, and the exotic species contains three sterols, which are absent in the native legumes. Genetically based differences between beetles adapted to different hosts, plastic responses toward new hosts, and chemical differences among seeds are important in host colonization and recognition of the exotic host. In conclusion, the generalist nature of S. limbatus does not influence its ability to colonize L. leucocephala. Explanations for the colonization of exotic hosts by generalist native species and for the success of invasive species must be complemented with studies measuring local adaptation and plasticity.
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Besouros , Oviposição , Sementes , Animais , Fabaceae , Feminino , HerbivoriaRESUMO
Introducción: En la actualidad es ampliamente aceptada la metformina como manejo farmacológico inicial para el tratamiento de la diabetes mellitus tipo 2 (DMT2). Resulta, sin embargo, controversial si en algunos tipos de pacientes puede iniciarse tratamiento únicamente con cambios intensivos de estilo de vida o si existen grupos en quienes debería iniciarse desde el inicio terapia farmacológica combinada. Objetivo: Definir el impacto de estrategias de cambio intensivo en la dieta y de ejercicio, así como de la terapia farmacológica con metformina asociada a un segundo antidiabético oral como estrategias de manejo inicial en pacientes con DMT2 recién diagnosticada. Métodos: Se elaboró la guía de práctica clínica, siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social colombiano. Se revisó la evidencia disponible de forma sistemática y se formularon las recomendaciones utilizando la metodología GRADE. Conclusiones: En pacientes con DMT2 recién diagnosticada no se recomienda el manejo únicamente con cambios intensivos del estilo de vida; estos deben acompañar el manejo farmacológico con metformina, dando prelación a los componentes de la dieta mediterránea y al ejercicio aeróbico. En los pacientes con DMT2 recién diagnosticada y niveles de HbA1C > 8 % se recomienda utilizar terapia combinada desde el inicio con metformina y otro antidiabético oral, siendo de primera elección los inhibidores de DPP-4.
Introduction: Today, metformin is widely accepted as standard initial pharmacologic treatment for diabetes mellitus type 2 (DMT2). However, it is controversial if in some groups of patients, the treatment can be initiated only with life style changes, or if there are groups who should begin with combined therapy since the beginning. Aim: To define the effect of intensive strategies for change of diet or exercise, and the effect of combined therapy with metformin and a second oral antidiabetic, as initial treatment in patients with newly DMT2. Methods: A clinical practice guide has been developed following the broad outline of the methodological guide from the Colombian Ministry of Health and Social Welfare. with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. Conclusions: In patients with recently diagnosed DMT2, initial treatment with lifestyle changes only is not recommended. However, it is recommended that lifestyles changes must begin simultaneously with metformin, including the components of a Mediterranean diet and aerobic exercise. In patients with recently diagnosed DMT2 and HbA1c levels >8%, it is recommended to administer a combined therapy from the beginning with metformin and another oral antidiabetic medication. The DPP4 inhibitor is recommended.
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Humanos , Diabetes Mellitus Tipo 2 , Tratamento Primário , MetforminaRESUMO
In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.
En Colombia la Diabetes Mellitus es un problema de salud pública por lo que deben generarse e implementarse estrategias de prevención, diagnóstico, tratamiento y seguimiento, aplicables en todos los niveles de atención con miras a establecer el control de la diabetes en forma temprana y sostenida. Se elaboró una guía de práctica clínica siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social para recolectar de forma sistemática la evidencia científica y formular las recomendaciones utilizando la metodología GRADE. El presente documento muestra, de forma resumida, el resultado de ese proceso, incluyendo las recomendaciones y las consideraciones tenidas en cuenta para llegar a ellas. En términos generales, se propone un proceso de tamización mediante el cuestionario FINDRISC adaptado a población Colombiana que permite llegar a un diagnóstico temprano de la enfermedad y un algoritmo para el manejo inicial que es generalizable a la gran mayoría de los pacientes con diabetes mellitus tipo 2 y que es sencillo de aplicar en atención primaria. También se hacen unas recomendaciones para escalar el tratamiento farmacológico de los pacientes que no alcanzan la meta o la pierden con el manejo inicial, teniendo en cuenta principalmente la evolución del peso y la individualización de la meta de control glucémico en poblaciones especiales. Finalmente se proponen algunas recomendaciones para la detección oportuna de las complicaciones micro y macrovasculares de la diabetes.
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Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Adulto , Fatores Etários , Idoso , Albuminúria/diagnóstico , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Colômbia , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta para Diabéticos , Quimioterapia Combinada , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/uso terapêutico , Estilo de Vida , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
In Colombia, diabetes mellitus is a public health program for those responsible for creating and implementing strategies for prevention, diagnosis, treatment, and follow-up that are applicable at all care levels, with the objective of establishing early and sustained control of diabetes. A clinical practice guide has been developed following the broad outline of the methodological guide from the Ministry of Health and Social Welfare, with the aim of systematically gathering scientific evidence and formulating recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The current document presents in summary form the results of this process, including the recommendations and the considerations taken into account in formulating them. In general terms, what is proposed here is a screening process using the Finnish Diabetes Risk Score questionnaire adapted to the Colombian population, which enables early diagnosis of the illness, and an algorithm for determining initial treatment that can be generalized to most patients with diabetes mellitus type 2 and that is simple to apply in a primary care context. In addition, several recommendations have been made to scale up pharmacological treatment in those patients that do not achieve the objectives or fail to maintain them during initial treatment. These recommendations also take into account the evolution of weight and the individualization of glycemic control goals for special populations. Finally, recommendations have been made for opportune detection of micro- and macrovascular complications of diabetes.
En Colombia la Diabetes Mellitus es un problema de salud pública por lo que deben generarse e implementarse estrategias de prevención, diagnóstico, tratamiento y seguimiento, aplicables en todos los niveles de atención con miras a establecer el control de la diabetes en forma temprana y sostenida. Se elaboró una guía de práctica clínica siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social para recolectar de forma sistemática la evidencia científica y formular las recomendaciones utilizando la metodología GRADE. El presente documento muestra, de forma resumida, el resultado de ese proceso, incluyendo las recomendaciones y las consideraciones tenidas en cuenta para llegar a ellas. En términos generales, se propone un proceso de tamización mediante el cuestionario FINDRISC adaptado a población Colombiana que permite llegar a un diagnóstico temprano de la enfermedad y un algoritmo para el manejo inicial que es generalizable a la gran mayoría de los pacientes con diabetes mellitus tipo 2 y que es sencillo de aplicar en atención primaria. También se hacen unas recomendaciones para escalar el tratamiento farmacológico de los pacientes que no alcanzan la meta o la pierden con el manejo inicial, teniendo en cuenta principalmente la evolución del peso y la individualización de la meta de control glucémico en poblaciones especiales. Finalmente se proponen algunas recomendaciones para la detección oportuna de las complicaciones micro y macrovasculares de la diabetes.
Assuntos
Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/terapia , Hemoglobinas Glicadas/análise , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Inquéritos e Questionários , Fatores Etários , Colômbia , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta para Diabéticos , Albuminúria/diagnóstico , Quimioterapia Combinada , Hipoglicemiantes/uso terapêutico , Estilo de VidaRESUMO
La masificación de la radiología digital ha hecho posible el estudio de diferentes patologías mediante imágenes de alta calidad diagnóstica. Existen diferentes patologías que afectan al tejido óseo, y que producen pérdida del mineral(1). Aquellas patologías se caracterizan por la pérdida de la arquitectura trabecular y un adelgazamiento de la cortical(7), visibles en la radiología. Aquellos cambios llevan al paciente a caer en el riesgo de sufrir futuras fracturas(8), por lo que se considera importante realizar un análisis de la geometría de las trabéculas ante este tipo de patología, con el fin de prever riesgos de fractura. Material y Métodos. Para realizar este estudio, se escogió un fémur de bovino(19). Este fue sumergido en ácido acético al 4 por ciento, con el fin de producir su desmineralización. Se le realizó una medición cada 24 horas mediante la adquisición de imágenes radiológicas, que fueron obtenidas con un equipo digital directo hasta observar cambios radiológicos evidentes en la población trabecular. Las imágenes fueron evaluadas mediante un software de libre acceso llamado ImageJ®(23), realizando mediciones trabeculares mediante la herramienta ROI, y se adquirieron los valores de área, perímetro y circularidad. Resultados. En las 10 trabéculas estudiadas se observaron y cuantificaron cambios en la arquitectura trabecular, aumentando el área en un 124 por ciento, el perímetro en un 53 por ciento y la circularidad se mantuvo en promedio constante. Conclusiones: Mediante la radiología digital, es posible evaluar la arquitectura trabecular mediante parámetros geométricos, los cuales nos indican que existen cambios muy pequeños a lo largo del tiempo. Se observó un aumento de tamaño en las trabéculas, pero sin pérdida de su forma.
Introduction. The mass use of digital radiology has made possible the study of different pathologies through high quality diagnostic images. There are different diseases that affect bone tissue and which produce mineral loss (1). Those diseases are characterized by loss of trabecular architecture and cortical thinning (7), visible in radiology. Those changes lead the patient to suffer the risk of future fractures (8), therefore it is considered important to analyze the geometry of the trabeculae in this kind of pathology in order to anticipate fracture risk. Material and Methods. For this study, a bovine's femur was chosen(19). This was immersed in 4 percent acetic acid to produce demineralization. Measurement was performed (in Clinica Alemana Santiago) every 24 hours by radiological imagings, which were obtained with digital radiology (DR) to observe obvious radiological changes in trabecular population. The images were evaluated by a freely available software called ImageJ® (23), by performing Trabecular measurements using the ROI tool, acquiring the values of area, perimeter and circularity. Results. In the 10 trabeculae studied, we observed and quantified changes in trabecular architecture, increasing the value of average area in 124 percent, perimeter in 53 percent and no change in circularity during the demineralization process. Conclusions. With digital radiography, it is possible to evaluate the trabecular architecture using geometric parameters, which indicate that there are very small changes over time. An increase in size of the trabeculae was observed, trabeculae was observed, but without loss of shape.
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Animais , Desmineralização Patológica Óssea/induzido quimicamente , Fêmur/patologia , Fêmur , Intensificação de Imagem Radiográfica/métodos , Interpretação de Imagem Radiográfica Assistida por Computador , Descalcificação Patológica/induzido quimicamente , Fatores de Tempo , Técnica de Desmineralização Óssea/métodos , Ácido AcéticoRESUMO
Due to their natural origin, apparent low oral toxicity, effectiveness, and accessibility without a medical prescription, the anthranoid laxatives are a popular remedy for constipation and are frequently used abusively. Therefore, it is important to characterize its harmful and/or toxic effects. The sennosides, main active metabolites of senna, exhibit a very low toxicity in rats, and its genotoxic activity in bacterial strains as well as mammal cells was classified as weak in those cases where it was shown to be significant. The toxicological and mutagenic status of the crude extract of senna, however, is not as well characterized, and it is necessary to do so since it is frequently, and at the same time incorrectly, believed that the chronic use of anthranoid laxatives is a risk factor for the development of colorectal cancer. The objective of this article was to review the information that arises in various scientific medical databases using key words such as senna, sen, Senna alexandrina, Cassia angustifolia, sennosides, laxative toxicity, mainly ISI and non-ISI articles of journals with an editorial committee. Web pages of products or companies that publicize or commercialize this type of laxative were not included. This analysis establishes that (1) there is no convincing evidence that the chronic use of senna has, as a consequence, a structural and/or functional alteration of the enteric nerves or the smooth intestinal muscle, (2) there is no relation between long-term administration of a senna extract and the appearance of gastrointestinal tumors or any other type in rats, (3) senna is not carcinogenic in rats even after a two-year daily dose of up to 300 mg/kg/day, and (4) the current evidence does not show that there is a genotoxic risk for patients who take laxatives containing senna extracts or sennosides.
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AIM: The purpose of this investigation was to evaluate the ability of cat's claw, an Amazonian medicinal plant, to treat osteoarthritis of the knee, collect safety and tolerance information and compare the antioxidant, and anti-inflammatory actions of Uncaria guianensis and Uncaria tomentosa in vitro. MATERIALS AND METHODS: Forty-five patients with osteoarthritis of the knee were recruited, 30 were treated with freeze-dried U guianensis, and 15 with placebo. Hematological parameters were assessed on entry and exit of the four-week trial. Pain, medical and subject assessment scores and adverse effects were collected at weeks 1, 2 and 4. The antioxidant and anti-inflammatory activity of the cat's claw species was determined by the alpha,alpha-diphenyl-beta-picrylhydrazyl (DPPH) free radical scavenging method. Inhibition of TNFalpha and prostaglandin E2 (PGE2) production was determined in RAW 264.7 cells by ELISA. RESULTS: Cat's claw had no deleterious effects on blood or liver function or other significant side-effects compared to placebo. Pain associated with activity, medical and patient assessment scores were all significantly reduced, with benefits occurring within the first week of therapy. Knee pain at rest or at night, and knee circumference were not significantly reduced by cat's claw during this brief trial. In vitro tests indicated that U guianensis and U. tomentosa were equivalent at quenching DPPH radicals (EC50, 13.6-21.7 microg/ml) as well as inhibiting TNFalpha production. However, the latter action was registered at much lower concentrations (EC50, 10.2-10.9 ng/ml). Cat's claw (10 microg/ml) had no effect on basal PGE2 production, but reduced LPS-induced PGE2 release (P < 0.05), but at higher concentrations than that required for TNFalpha inhibition. CONCLUSION: Cat's claw is an effective treatment for osteoarthritis. The species, U guianensis and U tomentosa are equiactive. They are effective antioxidants, but their anti-inflammatory properties may result from their ability to inhibit TNFalpha and to a lesser extent PGE2 production.
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Unha-de-Gato/química , Articulação do Joelho , Osteoartrite/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Plantas Medicinais/química , Adulto , Idoso , Dinoprostona/biossíntese , Método Duplo-Cego , Sequestradores de Radicais Livres/uso terapêutico , Liofilização , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/efeitos dos fármacos , Extratos Vegetais/efeitos adversos , Estudos Prospectivos , Antagonistas de Prostaglandina/uso terapêutico , Fator de Necrose Tumoral alfa/biossínteseRESUMO
Myiasis is the parasitism of organs and tissues of warm-blooded vertebrates by flies larvae. D hominis is a flie geographically restricted to tropical America from Mexico to northern Argentina. The adult flie, which is not hematophagous, needs to put its eggs on the abdominal surface of hematophagous arthropods which serve as carriers of future larvae which are deposited on the skin of the hosts (mammals, birds and accidentally men) when biting. Seven patients (two females) aged 7 to 35 years old, of different nationalities, recalled receiving mosquito bites, after staying in tropical American areas in the previous forty days. They presented furuncle-like lesions in exposed surfaces of the body. These lesions, 2-3 cm long, pruritic and mildly tender, broke and released a serous or serohematic fluid. Through the resulting opening, it was possible to partially observe the larva. Larvae were extracted by manual pressure (4) or surgical incision (3) and identified as D hominis larvae. Diagnosis of dermatobiasis, an imported myiasis, must be based on the characteristics of lesions and the previous residence in endemic areas of America.
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Miíase/diagnóstico , Dermatopatias Parasitárias/diagnóstico , Adulto , Criança , Feminino , Humanos , Masculino , Miíase/terapia , Dermatopatias Parasitárias/terapiaRESUMO
Objetivo: Establecer la prevalencia de la infección por chlamydia trachomatis en una población con problemas de la reproducción. Diseño: estudio descriptivo epidemiológico realizado entre julio de 1997 y junio de 1998. Material: A 140 parejas con problemas de reproducción, atendidas en la Unidad de Reproducción Humana del Hospital Nacional Edgardo Rebagliati Martins de EsSalud, se les tomó muestra endocervical (mujeres) o uretral (hombres) para detección de clamidia. Medidas de estudios: Detección de presencia de chlamydia trachomatis por método de inmunofluorescencia directa, IgG e IgA. Resultados: Al estudio de antígeno de clamidia por inmunofluorescencia directa, 122 (43,6 por ciento) pacientes fueron positivos, en 59,8 por ciento en ambos miembros de la pareja. La mayoría de los pacientes no presentó síntomas, en 23 por ciento no hubo alteración del espermatograma, a pesar de ser positivo a clamidia y, en las mujeres, la mayoría mostró alteraciones tubáricas a la laparoscopia y un 12 por ciento microvesículas en la serosa. Conclusión: La prevalencia de infección por clamidia en parejas con infertilidad en nuestro medio es alta, lo que debe ser considerado en los protocolos de manejo en reproducción, para diagnóstico y tratamiento, así como para tomar medidas adecuadas de prevención.
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Humanos , Masculino , Feminino , Doenças Bacterianas Sexualmente Transmissíveis/patologia , Chlamydia trachomatis , Prevalência , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Infertilidade/complicações , Hospitais Estaduais , Epidemiologia Descritiva , Estudos EpidemiológicosRESUMO
1. The analgesic effect of clonixinate of L-lysine (Clx) in the nociceptive C-fiber reflex in rat and in the writhing test in mice is reported. 2. Clx was administered by three routes, i.v., i.t. and i.c.v., inducing a dose-dependent antinociception. 3. The antinociceptive effect of Clx was 40-45% with respect to the control integration values in the nociceptive C-fiber reflex method. 4. The writhing test yielded ED50 values (mg/kg) of 12.0 +/- 1.3 (i.p.), 1.8 +/- 0.2 (i.t.) and 0.9 +/- 0.1 (i.c.v.) for Clx administration. 5. Ondansetron was not able to antagonize the antinociception response of Clx in the algesiometric tests used. 6. Chlorophenilbiguanide did not produce any significative change in the analgesic effect of Clx in the nociceptive C-fiber reflex method. 7. It is suggested that the mechanism of action of the central analgesia of Clx is not mediated by 5-HT3 subtype receptors.
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Lisina/farmacologia , Fibras Nervosas/efeitos dos fármacos , Receptores de Serotonina/efeitos dos fármacos , Analgesia , Animais , Relação Dose-Resposta a Droga , Vias de Administração de Medicamentos , Feminino , Masculino , Camundongos , Camundongos Endogâmicos , Dor , Ratos , Ratos Sprague-Dawley , Fatores de TempoRESUMO
Diffuse intralobular fibrosis of the liver is rare in cases of New World visceral leishmaniasis. A patient with this disease from a newly endemic area in the northernmost area of the Brazilian Amazon region was studied. Hypertrophy and hyperplasia of the phagocytic mononuclear cell system were observed, with parasitism and Disse's space fibrosis diffusely involving the liver. This description is based on a biopsy carried out after seven days of treatment with Glucantime. Another biopsy performed almost two years later showed no fibrosis, no Kupffer cell hypertrophy and hyperplasia, and no parasitism. The mechanism of fibrosis and regression is discussed.
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Leishmania infantum , Leishmaniose Visceral/complicações , Cirrose Hepática/etiologia , Fígado/patologia , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Adolescente , Animais , Antígenos de Protozoários/análise , Brasil , Hepatomegalia , Humanos , Imuno-Histoquímica , Células de Kupffer/parasitologia , Células de Kupffer/patologia , Leishmania infantum/imunologia , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/patologia , Fígado/parasitologia , Fígado/ultraestrutura , Cirrose Hepática/patologia , Masculino , Antimoniato de Meglumina , Microscopia Eletrônica , EsplenomegaliaRESUMO
As an alternative to lobectomy and in order to preserve lung tissue which may be potentially functional we have selectively intubated the right main bronchus in four infants 12 to 25 days old with severe, pulmonary interstitial emphysema of the left lung. In each case the localized hyperinflation disappeared within 5 to 48 hours of contralateral selective bronchial intubation. The duration of SBI was 1.5 to 5 days. Three patients benefited from the procedure; there were no serious complications. We propose that SBI should be tried in infants with severe, localized PIE which has caused mediastinal shift, compressive atelectasis, and respiratory acidosis requiring mechanical ventilation despite vigorous pulmonary therapy and usual supportive measures.